Super-Resistant Bacteria in Your Chicken Dinner

Of Birds and Bacteria
Consumers Union Report 11dec02

"Superbugs" that resist the usual antibiotic treatments are nasty,
and they could be in your chicken dinner. Here's how to protect yourself.

In the fall of 1997, almost three-fourths of the broilers that Consumer
Reports bought in stores nationwide harbored salmonella or campylobacter--the
bacteria most likely to give Americans food poisoning. Our new tests revealed
contamination in about half of the chickens we analyzed, but there's a dark
cloud within that silver lining. Many of the contaminated chickens harbored
strains of salmonella and campylobacter that are resistant to antibiotics
commonly used against those bugs, which can cause fever, diarrhea, and abdominal
cramps.

As a result, the estimated 1.1 million or more Americans sickened each year
by undercooked, tainted chicken, or by food that raw chicken juices have
touched, may stay sick longer, possibly with more serious illnesses. Doctors may
have to prescribe several antibiotics before finding one that works. And
patients may have to pay more to be treated.

For what is, to our knowledge, the largest nationally representative analysis
of antibiotic resistance in store-bought chicken, we tested 484 fresh, whole
broilers bought at supermarkets and health-food stores in 25 cities nationwide
last spring. Represented in our tests were 4 leading brands (Foster Farms,
Perdue, Pilgrim's Pride, and Tyson), 14 supermarket brands, 9 premium brands
(usually from smaller companies, usually more expensive, labeled as raised
without antibiotics, and including free-range and organic brands), and 2 kosher
brands.

Our shoppers packed the raw birds in coolers and shipped them overnight to a
lab. There, tests determined whether salmonella and campylobacter were present,
showed whether those bacteria were resistant to a range of human antibiotics,
and measured the chickens' total plate count, an indicator of spoilage. Key
findings:

Campylobacter was present in 42 percent of the chickens, salmonella in 12
percent. Five percent of all chickens had both campylobacter and salmonella; 51
percent had neither.

No major brand was less contaminated than others overall. Pilgrim's Pride had
an exceptionally low incidence of salmonella but, along with Tyson, a higher
incidence of campylobacter than most other brands.

All 12 samples from Ranger, a premium brand sold only in the Northwest, were
free of campylobacter and salmonella. Ranger's chickens also had among the
fewest bacteria that can cause spoilage. Ranger was the only brand that was
clean across the board.

Ninety percent of the campylobacter bacteria tested from our chicken and 34
percent of the salmonella showed resistance to one or more antibiotics.

To see whose chickens harbored bacteria and how many of those bacteria
remained unaffected by antibiotics, see How contaminated? How resistant?. We've
also deciphered the claims you're likely to find on packages of chicken,
including free-range, organic, and natural, in Behind the labels.

HOLES IN THE SAFETY NET

Since 1998, a federally mandated system called HACCP (pronounced hass-ip) has
been the consumer's main protection against contaminated poultry, meat, and
seafood. The initials stand for Hazard Analysis and Critical Control Points, and
the system requires chicken producers to spell out where contamination might
occur during processing, then build in procedures to prevent it.

After slaughter, for instance, chickens typically become contaminated with
bacteria naturally found in their digestive tract, so processors spray carcasses
inside and out with an approved disinfectant. Later, the birds are submerged in
an icy wash that must chill them from about 100' F to below 40'.

U.S. Department of Agriculture (USDA) inspectors monitor HACCP plans and sit
on production lines, rejecting carcasses that pass by with visible signs of
illness or filth. They also test random samples for the presence of salmonella,
but, unfortunately, not for campylobacter. Studies that could create a standard
for campylobacter testing are under way, a USDA spokesman says, but no time
frame has been set for putting tests in place.

According to the Centers for Disease Control and Prevention (CDC), there has
been a significant reduction in major foodborne illnesses since HACCP was
implemented. Still, the system has shortcomings. USDA inspectors at meat and
poultry plants are failing to spot faults in HACCP plans, according to a report
issued last August by the General Accounting Office, the government watchdog
agency. The agency concluded that inspectors missed problems or, when they found
them, didn't require quick corrections. "As a result," the report
said, "consumers may be unnecessarily exposed to unsafe foods that can
cause foodborne illnesses."

HACCP protections have become even more important with the discovery of
chickens harboring antibiotic-resistant strains of campylobacter, salmonella,
and enterococcus (a germ linked with deadly hospital-acquired infections).

Antibiotics--which may include, experts say, low doses of human drugs such as
penicillin, erythromycin, and tetracycline--are given to chickens to prevent or
reduce sickness and to speed growth. That practice is based on studies dating to
the 1950s that showed animals given antibiotics reach their market weight
faster, though perhaps only a day faster, than untreated animals.

When birds actually get sick, perhaps with respiratory disease from
Escherichia coli picked up from their own droppings, they need full-strength
antibiotics for a short time. Flocks are too big for veterinarians to treat
individual birds, so all birds may receive antibiotics in their drinking water.

These drugs kill not only the bacteria that cause chickens to become sick,
but also some of the many other types of bacteria that normally live inside
chickens. Their routine use in so many birds sets the stage for the evolution of
drug-resistant microbes that multiply around chicken coops, each of which can
hold up to 20,000 birds. Bacteria that survive drug treatment may eventually
contaminate carcasses during slaughtering and processing. And if chicken isn't
cooked thoroughly enough to kill those bacteria, they could end up on your
dinner plate, then colonize your intestines.

Antibiotic-resistant bacteria can enter your system from an outside source,
such as undercooked chicken, but bacteria that normally live inside you can also
develop resistance--as a result, for example, of the overuse or misuse of
prescription antibiotics.

In either case, once the bacteria are in you, they may stay. Some stay for a
short time, causing acute illness; others live peacefully in your digestive
tract only to cause hard-to-treat disease when transferred to the bloodstream or
urinary tract. Danish researchers recently found that when healthy volunteers
ate just one meal contaminated with antibiotic-resistant strains of the
bacterium Enterococcus faecium that came from chicken or pork, the bug lingered
in the volunteers' intestinal tracts for up to 14 days. Antibiotic-resistant E.
faecium does not cause disease if confined to your intestines, but if it escapes
into your bloodstream, say during surgery, it can be fatal.

Also disheartening is that resistance can be "catching." Certain
bacteria tend to carry their resistance genes on circular strips of DNA, called
plasmids, that can move to other bacteria, conferring resistance upon them as
well. Antibiotic-resistant bacteria in undercooked chicken, for instance, could
pass on their resistance to other bacteria already living in your intestines and
make it hard to treat any infection those bacteria might eventually cause.

Although stronger-than-usual or extended doses of antibiotics might
eventually kill the bugs in most people, resistant germs can be risky for the
very young, the very old, and people with weakened immune systems.

THE ROOTS OF RESISTANCE

What the CDC would later call a growing threat to public health was suspected
as early as 1952, when two University of California bacteriologists warned,
according to an article in Scientific American, that "chicks raised on
antibiotics may develop resistant bacteria and poison people who eat them."
The suspicion was confirmed in 1998, when CDC researchers studied
salmonella-tainted chickens and stool samples from people sickened by
salmonella. They found strains of the bacterium resistant to the human
antibiotic gentamicin, a drug routinely injected into chicken eggs to reduce the
chance of bacterial contamination.

In May 1999, investigators in Minnesota published findings that revealed the
presence of drug-resistant campylobacter in store-bought chicken. They also
found that newer fluoroquinolone antibiotics, such as the anthrax drug
ciprofloxacin (Cipro), had rapidly lost effectiveness against foodborne
campylobacter infections in people.

Food and Drug Administration (FDA) investigators concluded in October 2000
that two fluoroquinolone drugs made specifically for animals had spawned
drug-resistant campylobacter in chickens' intestinal tracts. One of the drugs
was quickly pulled off the market by its maker. The FDA proposed to withdraw
approval of the second drug for treating disease in poultry, but its maker,
Bayer, has challenged the proposal. Hearings were ongoing as of last fall.

Last September, the agency announced a proposal that companies submitting
animal drugs for FDA approval assess their potential to promote resistance in
humans.

The Animal Health Institute, which represents manufacturers of animal drugs,
says antibiotic resistance is a top concern. But it maintains that the use of
antibiotics in food animals poses an extremely small risk to human health and
that the increase of bacterial resistance to antibiotics in humans is largely
the result of overreliance on antibiotics in human medicine.

A spokesman for the National Chicken Council, an industry group, notes that
"a very large percentage" of antibiotics used in chickens are not
closely related to any drugs used in humans. The council also points to data
indicating that the overall usage of antibiotics in animals of all kinds has
been declining since 1999.

Indeed, four of the biggest U.S. poultry producers recently announced that
they have reduced their use of certain antibiotics. Last year, Tyson said it had
"chosen to discontinue its previously minimal use" of fluoroquinolone
antibiotics in broiler chickens. Perdue says it stopped using fluoroquinolones
last year. Foster Farms says it stopped using them approximately five years ago
and does not give other important human drugs to chickens except when they're
sick. Pilgrim's Pride says it stopped using fluoroquinolones in October 2000.

Margaret Mellon, director of the food and environment program at the Union of
Concerned Scientists, a nonprofit environmental group, applauds any cut in
antibiotic use. "You don't ever want to use antibiotics where you don't
need them," she says. "The rule in antibiotics is, if you use them you
lose them." But Mellon points out that industry data don't provide
specifics about antibiotic use and production that would be helpful in
monitoring ways to prevent drug resistance. The government doesn't collect such
data, either. "We know nothing," she says. "We are flying
blind."

Moreover, although the use of fluoroquinolones may have tapered off, at least
nine other antibiotics are approved for use in both chickens and humans, and
some are used in substantial quantities. For example, the Union of Concerned
Scientists estimates that more than 380,000 pounds of erythromycin are given to
poultry every year to hasten growth and prevent disease.

Our tests support the need for continued concern.

WHAT WE FOUND

Overall, chicken had less bacterial contamination than in our 1997 study, but
it was still far from pristine, and there was widespread antibiotic resistance
in the bacteria.

Contamination. You need swallow just 15 to 20 salmonella bacteria, or about
500 campylobacter, to become ill. Both bugs can cause intestinal distress.
Campylobacter can also cause serious complications, including meningitis,
arthritis, and Guillain-Barré syndrome, a severe neurological disorder.

Of all the chickens we tested, 42 percent harbored campylobacter--down from
63 percent in our 1997 tests. Among big brands, incidence ranged from 34
percent, in Perdue, to 56 percent, in Tyson. Supermarket brands as a whole were
in the middle of that range.

Twelve percent of all chickens harbored salmonella, as against 16 percent in
1997. Pilgrim's Pride had an extremely low incidence of salmonella: Only 1
percent of its chickens were contaminated. (Pilgrim's Pride was in the news for
less laudable reasons last October, when a company it owns recalled more than 27
million pounds of cooked turkey and chicken deli meat. The meat was possibly
contaminated with listeria bacteria.)

As a group, the premium chickens were not significantly more free of microbes
than others. On average, 33 percent were contaminated with campylobacter; 12
percent with salmonella. That said, the five premium brands labeled organic or
free-range had no salmonella, and one of those, the free-range Ranger, also had
no campylobacter, at least in the 12 samples we tested. We wondered whether
Ranger's birds were treated differently from most others, so, without revealing
our results, we checked with Rick Koplowitz, chief executive officer of Draper
Valley Farms, which raises Ranger chickens. His answer revealed no unusual HACCP
steps that would have made those birds cleaner.

Both kosher brands represented in our tests, Empire and Rubashkin's Aaron's
Best, had a relatively high incidence of salmonella: Five of 20 samples of
Empire and 1 of 6 samples of Aaron's tested positive. The incidence of
campylobacter in Empire's chickens was slightly lower than the average for all
chickens. None of Aaron's chickens had campylobacter.

We're still pondering one interesting result from our tests: Of 97 chickens
from three processing plants in the Southwest and sold under the Pilgrim's Pride
or Tyson name, only one harbored salmonella. That could result, perhaps, from
drier weather or different processes in the plants. In any case, a Southwestern
origin didn't make a difference when it came to campylobacter.

Spoilage. As a check of freshness, we measured total plate count, testing
chickens for a broad class of bacteria whose presence in large numbers can make
foods smell or feel slimy, though they generally don't make you sick. Only 12 of
the broilers we tested, or 2 percent, had a total plate count high enough to
suggest they were almost spoiled. That's a bit better than in our 1997 study,
when we found 5 percent of birds had nearly gone bad. The 12 in this study came
from 6 different brands. Chickens from the premium brand Bell & Evans were
relatively high in spoilage bacteria. It's possible that those birds stayed in
the case too long: Some Bell & Evans birds we bought didn't have a sell-by
date.

Antibiotic resistance. Despite the chicken producers' announcements and the
premium-chicken label claims, antibiotic resistance is still a concern,
especially in chickens harboring campylobacter.

Our tests showed that if you are sickened by one of those chickens, two
commonly used antibiotics--tetracycline, an older but still important drug used
against germs from pneumonia to chlamydia, and erythromycin, an option for
patients allergic to penicillin--may not help. In 66 percent of the
campylobacter-contaminated chickens, the bacteria were resistant to
tetracycline. In 20 percent, they were resistant to erythromycin.

Your chances of being cured by the usual doses of two fluoroquinolones,
ciprofloxacin and ofloxacin, may also be limited. The latest figures from the
FDA, reported in 2001, indicate that 11,477 Americans were infected in 1999 by
fluoroquinolone-resistant campylobacter in chicken.

Antibiotic-resistant campylobacter appeared even in chickens from the two
brands labeled "certified organic," Rosie and Springer Mountain Farms.
That isn't as surprising as it might sound. Although antibiotics are not allowed
in organic poultry, and farmers must demonstrate to organic certifiers that they
have not been used, antibiotic-resistant bacteria are ubiquitous and can persist
in the environment for years. In any case, we learned after our tests were
finished that Springer Mountain Farms had taken the organic claim off its label.

In 19 percent of the chickens contaminated with salmonella, the bacteria were
resistant to ampicillin, used against a dozen or more different bacterial
infections. In 17 percent, bacteria were resistant to tetracycline.

Six salmonella-tainted samples from the two kosher-chicken companies showed
no antibiotic resistance.

RECOMMENDATIONS

Chicken becomes contaminated long before you put it in your shopping cart.
For that reason, the first line of attack needs to be a change in food-safety
policies. But because consumers are the last line of defense against unsafe
food, we've also listed steps you can take.

What policymakers can do:

The government should require companies to monitor data on the use of
antibiotics in food animals.

Congress should ban subtherapeutic uses of medically important drugs in
poultry and other livestock.

The USDA should extend its food-safety program to include testing for
campylobacter in poultry plants, should better train its inspectors to spot
deficiencies, and should require speedy fixes.

What you can do:

Make chicken one of the last items you buy before heading to the checkout
line.

Pick chicken that is well wrapped and at the bottom of the case, where the
temperature should be coolest. Sell-by dates are not a perfect indicator of
freshness. We found a few spoiled chickens with sell-by dates as far away as
four to six days. If you can find a chicken with a sell-by date seven or
more days away, buy it.

Place chicken in a plastic bag like those in the produce department, to
keep its juices from leaking.

If you'll be cooking the chicken within a couple of days, store it at
below 40' F. Otherwise, freeze it.

Thaw frozen chicken in a refrigerator or microwave oven, never on a
counter. Leave it in its packaging and put it on a plate, so juices can't
drip.

Separate raw chicken from other foods. Immediately after preparation, use
hot, soapy water and paper towels to wash and dry your hands and anything
you or raw chicken might have touched.

Cook chicken thoroughly to kill harmful bacteria. Whole chicken should be
heated to 180' F, breasts to 170'. Use a thermometer; chicken that is no
longer pink can still harbor bacteria.

Don't return cooked meat to the plate that held it raw. And don't use a
sauce in which raw chicken has been marinating unless it has been brought to
a rolling boil for at least a minute.

Refrigerate or freeze leftovers within two hours of cooking.

The numbers

HOW CONTAMINATED?

Below, the percent of tested chickens that harbored the two main foodborne
disease-causing bacteria. For each major brand, we analyzed, on average, about
75 chickens; for supermarket brands, we analyzed a total of 75; for premium
brands, a total of 82. If salmonella and campylobacter hitched a ride on the
same carcass, consumers would have a good indication of what not to buy, but the
presence of the two bugs often didn’t track, as is evident with Pilgrim’s
Pride. Brands are ranked based on contamination with campylobacter, which is
more prevalent than salmonella and more likely to be resistant to common
antibiotics.

To qualify for our test of antibiotic resistance, a chicken had to be
contaminated with campylobacter or salmonella. We then tested whether those
germs were resistant to major antibiotics often used to treat people.
"Somewhat resistant" means that the growth of bacteria on a sample of
chicken was inhibited, but not stopped, by an antibiotic at a normal dosage. If
you were to become infected with such bacteria, it could take longer--or require
more than the typical dosage--for antibiotics to cure you. "Resistant"
means that the bacteria survived a normal dose of the antibiotic and would
therefore continue to make you sick. Your doctor would then have to prescribe a
different antibiotic and hope that it would do the trick.

Tests of antibiotic resistance were performed on campylobacter from 155
chicken samples and on salmonella from 58 chicken samples. Because the
relatively small sample size limits the meaningfulness of differences among
brands and even categories of chicken, the table shows drug sensitivity across
all samples. Antibiotics are in alphabetical order.

How meaningful are the labels on chicken packages? Sometimes, not very. When
we visited one free-range chicken farm a few years ago, we found a penned,
10x30-foot patch of dirt topped with chicken manure and grass. A second
"range" consisted of a larger pen, but the birds chose to stay in a
small area filled with weeds and an old drum. Other labels are more meaningful.
Here's a primer. For more information on these labels and others, visit www.eco-labels.org,
a site sponsored by Consumers Union.

Free-farmed. The American Humane
Association has verified that the animals had, among other things, access to
clean water and food, and that no antibiotic was used for growth promotion.

Free-range, Free-roaming. Poultry has had
"access" to the outdoors, even if that means only that the door to
the coop was left open for a few hours.

Fresh. The bird's internal temperature has
never dropped below 24' F. Nevertheless, we've found plenty of
"fresh" chicken frozen hard as a rock.

Kosher. This poultry was prepared according
to Jewish dietary laws. Salt was added as part of the process.

Natural. No artificial ingredients or color
were added, and the bird was "minimally processed." This isn't a
helpful label, since there is no verification system.

No additives. Additives are agents such as
coloring, preservatives, or flavorings, including salt. The USDA and FDA share
authority over the approval of additives in meat and poultry, but there is no
standard guidance or verification for manufacturers using the "no
additives" label. Other chemicals, such as pesticides and antibiotics,
can still be used in producing chickens with this label.

No antibiotics. Chickens were raised
without such drugs, but unless the chicken has a certified "organic"
label, it is unlikely the claims have been verified.

No chemicals added. There's no standard
guidance or verification system for manufacturers using this label.
Antibiotics and additives are not legally classified as chemicals; presumably,
they could be added by a manufacturer using this label.

No hormones. The USDA prohibits the use of
hormones in raising poultry, so this claim could be used on all chickens.
Birds with this boast are just crowing about following the law.

Organic.
These chickens are certified as having been raised without the
use of most synthetic pesticides and fertilizers, antibiotics, genetic
engineering, irradiation, sewage sludge, and artificial ingredients.
[Emphasis added by mindfully.org]

Consumers Union
urges you to end Bayer's opposition to the proposed Food and Drug
Administration (FDA) ban on the use of Bayer's antibiotic, Baytril, in
treating chickens and turkeys.

Baytril is a
fluoroquinolone antibiotic, a class of drugs that also includes
ciprofloxacin (Cipro). Fluoroquinolones are considered one of the most
valuable classes of antibiotic drugs available to physicians treating
human patients because of their effectiveness against a broad range of
disease-causing bacteria and relative lack of side effects. Ciprofloxacin
is the antibiotic most often used to treat severe cases of food poisoning
caused by bacteria.

Consumers Union
recently conducted a nationally representative study of antibiotic
resistance in store-bought chicken in which we tested 484 fresh, whole
broilers bought in 25 metro areas nationwide last spring (study enclosed).
We found that 42% of the chickens were contaminated with Campylobacter. Of
the Campylobacter cultures isolated from samples of contaminated chickens,
26% were resistant to ciprofloxacin. This figure is higher than the data
from separate and independent tests conducted over the past three years by
the federal National Antibiotic Resistance Monitoring System (NARMS),
which found 13.2%, 9.9% and 11.3% of Campylobacter isolates from chicken
to be resistant to ciprofloxacin in 1998, 1999 and 2000, respectively.

The FDA has
determined that use of Baytril in poultry contributes to the development
of antibiotic resistance in bacteria that cause severe food poisoning in
humans and has proposed banning the use of all flouroquinolones in poultry
production. The American Medical Association and the Centers for Disease
Control and Prevention (CDC) have also supported the FDA's action in this
area.

Based on our own
independent study, Consumers Union agrees with the serious health concerns
raised by the FDA, and reiterated by the CDC and the American Medical
Association. In our opinion, the collective evidence of a mounting public
health problem is clear and compelling.

Therefore, we
urge you to follow the lead of Abbott Laboratories, which withdrew its
poultry drug in compliance with FDA's ban on flouroquinolones in poultry
production.

Rather than your
company's continuing its current sale of Baytril for use with poultry
production and contesting the FDA's proposed ban, we call on you, as
Bayer's new CEO, to show your company's concern for public health by
immediately and permanently withdrawing Baytril from the market for such
purposes.

WASHINGTON - Americans sickened by chicken contaminated with salmonella and
campylobacter may stay ill longer and pay more for treatment due to virulent
strains of the bacteria that resist common antibiotics, Consumers Union said on
Tuesday.

U.S. farmers have long used antibiotics to prevent contagious diseases in
livestock grown for food and to increase growth. Consumers Union and other
critics believe routinely feeding powerful antibiotics to livestock -- along
with overuse of the drugs in humans -- is producing bacteria that are more
difficult to treat.

In a nationwide analysis of brand-name poultry, the nonprofit publisher of
Consumer Reports magazine found 90 percent of the campylobacter found in the
poultry was resistant to one or more commonly used antibiotics, including
tetracycline and erythromycin. Of the chickens with salmonella, 34 percent were
resistant to antibiotics.

"Doctors may have to prescribe several antibiotics before finding one
that works," said Doug Podolsky, senior editor of the magazine. "And
patients may have to pay more to be treated."

The findings, published in the Consumer Report's January issue, were part of
a larger study on the prevalence of salmonella and campylobacter in chicken. The
bugs, which infect more than 1.1 million Americans annually, can cause fever,
diarrhea and abdominal cramps.

McDonald's Corp. MCD.N , Wendy's International Inc. WEN.N , Tyson Foods Inc.
TSN.N and closely held Perdue Inc. promised earlier this year that their poultry
products would be free of certain antibiotics.

NATIONWIDE STUDY

Consumer Union said it analyzed 484 raw chickens purchased at supermarkets in
two dozen U.S. cities. Of the chickens, 42 percent were contaminated with
campylobacter and 12 percent with salmonella.

Those rates of contamination were down significantly from the consumer
group's last study in 1997 that found 63 percent of chickens tested had
campylobacter and 16 percent had salmonella.

Raw chicken included in the study were sold by Tyson, Perdue, Pilgrim's Pride
Corp. CHX.N and privately held Foster Farms.

The National Chicken Council, which represents poultry farmers, said the
decline in salmonella and campylobacter contamination showed the industry was
taking the necessary steps against harmful bacteria.

The trade group also said it was misleading to focus on antibiotics
resistance.

"Resistance to bacteria is by no means limited to raw poultry,"
said Richard Lobb, spokesman for the trade group. "You have to look at its
long-term use in human health and its effect."

Poultry farmers say a key source of antibiotic resistance comes from U.S.
physicians being too quick to prescribe common antibiotics at the request of
patients.

CONGRESSIONAL ACTION NEEDED?

U.S. health officials have cautioned that some infections were becoming more
difficult to treat.

"Unfortunately, some salmonella bacteria have become resistant to
antibiotics, largely as a result of the use of antibiotics to promote the growth
of feed animals," according to documents previously issued by the U.S.
Centers for Disease Control and Prevention.

Consumers Union urged Congress to ban certain antibiotics in animals that are
also regularly used for people.

The Food and Drug Administration in September proposed stricter regulations
mandating drug companies to submit information about resistance risk when
applying for approval for new animal drugs.

The European Union has had a long-standing ban on sales of four antibiotics
for use in livestock feed. Other antibiotics are allowed, although some nations
like Denmark and Sweden have called for a halt to prolonged use.

Consumers Union also recommended that USDA begin testing at poultry plants
for campylobacter.

A USDA spokesman said the department was "laying the ground work"
on testing for the bacteria but declined to elaborate.

If
you have come to this page from an outside location click
here to get back to mindfully.org